Aksetin

Aksetin – generation cephalosporin II, the antibiotic of a broad spectrum of activity having antimicrobic and bactericidal effect.

Form of release and structure

Dosage form – powder for preparation of solution for intravenous and intramuscular administration: from white till light yellow color (in glass bottles, 1 bottle in a pack of cardboard or 100 bottles in a box cardboard (for hospitals)).

Active agent: tsefuroksy (in the form of sodium salt) in 1 bottle – 750 or 1500 mg.

Indications to use

Aksetin use for therapy of the following infectious and inflammatory diseases caused by microorganisms, sensitive to a tsefuroksim:

• Respiratory tracts: pneumonia, bronchitis, pleura empyema, lung abscess;
• ENT organs: otitis, pharyngitis, tonsillitis, sinusitis;
• Skin and soft tissues: pyoderma, ugly face, impetigo, phlegmon, furunculosis, contaminated wounds;
• Urinary tract: cystitis, chronic and acute pyelonephritis, gonorrhea, symptomatic bacteriuria;
• Bodies of a small pelvis: cervicitis, endometritis, adnexitis;
• Bones and joints: osteomyelitis and septic arthritis;
• Other infections: sepsis and meningitis, peritonitis, borreliosis (Lyme's disease).

Use of drug for prevention of infectious complications at surgical interventions on bodies of a basin, an abdominal cavity, thorax, joints is recommended, including at gullet, heart, lungs operations, at orthopedic operations, and also in vascular surgery with high risk of infectious complications.

Contraindications

Aksetin is strictly contraindicated only at hypersensitivity to his components, other cephalosporins, karbapenema or penicillin.

Drug should be used with care in the following cases:

• Exhaustion and weakening of patients;
• Diseases and bleedings of digestive tract (including nonspecific ulcer colitis), including in the anamnesis;
• Chronic renal failure;
• The period of a neonatality and prematurity at children;
• Period of pregnancy and lactation.

Route of administration and dosage

The solution prepared from powder enter intravenously (in/in) or intramusculary (in oil).

The adult usually appoint 750 mg 3 times a day, at the heavy course of an infectious disease the dose is increased up to 1500 mg by 3-4 times a day (an interval if necessary reduce till 6 o'clock). The average daily dose makes 3000-6000 mg.

To children 3 years usually are more senior appoint on 30-100 mg/kg/days in 3-4 receptions. The daily dose of 60 mg/kg in most cases is optimum.

To newborns and children up to 3 years – on 30 kg/kg/days in 2-3 receptions.

The recommended dosing modes:

• Gonorrhea: 1500 mg in oil once or on 750 mg 2 times with introduction to different areas (for example, both gluteuses);
• Bacterial meningitis: in/in, adults – on 3000 mg each 8 hours, children – on 150-250 mg/kg/days in 3-4 receptions, newborns – on 100 mg/kg/days;
• Pneumonia: in/in or 2-3 times, in oil on 1500 mg, a day within the first 2-3 days, then transfer the patient to the peroral drug containing tsefuroksy – on 500 mg 2 times a day on an extent of 7-10 days;
• Exacerbation of chronic bronchitis: in/in or 2-3 times, in oil on 750 mg, a day within the first 2-3 days, then transfer the patient to the peroral drug containing tsefuroksy – on 500 mg 2 times a day on an extent of 5-10 days;
• At lung, heart operations, vessels, a gullet: at anesthesia induction – 1500 mg in/in, then – 3 times/days, in oil on 750 mg, within 1-2 days;
• At orthopedic operations and operations on bodies of a basin, an abdominal cavity: at anesthesia induction – 1500 mg in/in, then – in oil on 750 mg in 8 and 16 hours after surgical intervention;
• At full replacement of a joint: 1500 mg of powder in a dry form mix with each package of polymer methyl - methacrylate cement before addition of liquid monomer.

At a chronic renal failure the dose is adjusted depending on the clearance of creatinine (CC): KK of 10-20 ml/minute – on 750 mg 2 times a day, KK less than 10 ml/minute – on 750 mg of 1 times a day.

To patients who are on a continuous hemodialysis using the arteriovenous shunt or on haemo filtering of high speed in intensive care unit appoint 750 mg 2 times a day. To the patients who are on haemo filtering of low speed appoint doses which apply at a renal failure.

Side effects

• From the alimentary system: ulcerations of a mucous membrane of an oral cavity, a glossitis, oral cavity candidiasis, spasms and an abdominal pain, a meteorism, vomiting or a lock, diarrhea, nausea, a pseudomembranous coloenteritis, a cholestasia, increase in activity of liver enzymes in plasma (aspartate aminotransferases, alaninaminotranspherases, an alkaline phosphatase, a lactate dehydrogenase, bilirubin);
• From system of a hemopoiesis: anemia (aplastic or hemolitic), thrombocytopenia, agranulocytosis, prothrombinopenia, eosinophilia, leukopenia, neutropenia, decrease in hemoglobin and hematocrit, lengthening of a prothrombin time;
• From an urinary system: a dysuria, a renal failure (increase in residual nitrogen of urea and creatinine in blood, decrease in clearance of creatinine);
• From a reproductive system: a vaginitis, an itch in a crotch;
• Allergic reactions: itch, rash, urticaria, fever; seldom – a bronchospasm, an acute anaphylaxis, Stephens-Johnson's syndrome, a multiformny erythema;
• Local reactions: pain, infiltrate and irritation in an injection site, phlebitis.

Special instructions

At patients in whose anamnesis allergic reactions to penicillin were noted hypersensitivity to tsefalosporinovy antibiotics is possible.

During treatment it is necessary to control functions of kidneys, especially at patients who receive Aksetin in high doses. At the infections caused by Streptococcus pyogenes, treatment should be continued within 48-72 hours after disappearance of symptoms of a disease. The recommended therapy duration – not less than 10 days.

If during treatment tsefuroksimy there is a need to determine glucose level in blood, it is necessary to apply tests with a hexokinase or glucose oxydas.

At children during therapy of meningitis decrease in hearing is possible.

At use of a tsefuroksim receiving false positive reaction of urine to glucose and false positive forward reaction of Koombs is possible.

At transfer of the patient with parenteral administration Aksetin into administration of drug containing tsefuroksy inside it is necessary to consider the general condition of the patient, sensitivity of microorganisms and weight of an infection. If in 3 days after reception of means inside clinical improvement is not noted, it is necessary to continue parenteral administration.

During treatment it is not necessary to take alcoholic beverages.

Medicinal interaction

Tsefuroksim pharmaceutical is compatible to the following means: xylitol, азлоциллин, the metronidazole, aqueous solutions containing to 1% of lidocaine of a hydrochloride, 5% solution of a dextrose, 0,9% solution of sodium of chloride, 4% solution of a dextrose and 0,18% solution of sodium of chloride, 5% solution of a dextrose and 0,45% solution of sodium of chloride, 10% solution of a dextrose, 5% solution of a dextrose and 0,225% chloride sodium solution, Ringer's solution, Hartman's solution, solution of sodium lactate, 5% solution of a dextrose and a hydrocortisone, 10% the inverted sugar in water for injections, potassium chloride (10 ¼Ý¬ó/l and 40 ¼Ý¬ó/l) in 0,9% chloride sodium solution, heparin (10 units/ml and 50 units/ml) in 0,9% chloride sodium solution.

Tsefuroksim pharmaceutical is incompatible with solution of sodium of bicarbonate of 2,74% and aminoglycosides.

The drugs reducing acidity of a gastric juice reduce absorption and bioavailability of a tsefuroksim.

At simultaneous use of aminoglycosides and diuretics the risk of emergence of nephrotoxic effects increases.

At simultaneous use of peroral loopback diuretics concentration in plasma increases and the elimination half-life of a tsefuroksim increases, there is a delay of canalicular secretion, the renal clearance decreases.

Terms and storage conditions

To store in the unavailable to children, protected from light, dry place at a temperature up to 25 ºС.

Period of validity – 2 years.

The solution prepared from powder is allowed to be stored within 48 hours in the refrigerator and within 7 hours – at the room temperature. For storage time solution can turn yellow, it is not a contraindication to its use.